Concluded Case

Cardiac case

A cardiac case 79 yrs old male , got bypass surgery done in 2004-2005 around , had surgery for cholelithiasis around few yrs back . Taking telmisartan 40 Omeprazole 40 + domperidone , arorvastatin 40 , aspirin , ativan( lorazepam) 2 mg , Now having tingling sensation at the tips of fingers and legs , pain in the rib of right ide of chest on bending or while pressing at that point. Agitation , numbness in the right hand ( as per him due to (pet )dog bite 2-3 yrs back taken arv as per schedule , a bit of low feelings. He has been taking ativan 2mg daily since the surgery as the doctor here told him that it’s necessary for him to take that medicine, without medicine he can’t sleep. His bp is around 130/80 , spo2 94- 97% RA, nausea feeling , fatigue and don’t want to do any work are the complaints. I suspect the long term use of lorazepam as the culprit, if its so please suggest the alternative method of treatment in this case sir. If not what would b the probable cause sir ??

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Concluded answer

Anxiety/Depression is quite common in cardiac cases whether stenting or CABG Would have been better if SSRI + Bzds was there to tackle sleep/anxiety/Depression Meanwhile, you can put him on Ativan 1mg for 2 weeks and then completely stop it, also start cap Becadexamin once daily in morning and tab calcimax forte at night Also get his Vit B12, D3

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Anxiety/Depression is quite common in cardiac cases whether stenting or CABG Would have been better if SSRI + Bzds was there to tackle sleep/anxiety/Depression Meanwhile, you can put him on Ativan 1mg for 2 weeks and then completely stop it, also start cap Becadexamin once daily in morning and tab calcimax forte at night Also get his Vit B12, D3

Thank you doctor
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Rx HRT 2bd Arjunarostha 20ml bd Galo ghan 1 tab bd

Anxiety neurosís B12 deficiency

Rx Multivitamins, psychiatric consultation

? Anxiety.. ? Drug induced...

Ad v replacement of b12 folic acid thiamine. Anxiolytics Sos psychiatrist opinion

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0

Depression Senile dermatitis Ref to psycatrist

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Tingling sensation may be d/t vit B12 deficiency or any neuropathy.in place of lorazepam you can use cloze .25 mg

Thank you doctor
1

B12 deficiency, Anxiety and Depression are reasons behind such sensations... Can change to newer safer sleep medicines after consultation with Psychiatrist

Thank you doctor
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? ANXIETY NEUROSIS.. ? DRUG DEPENDENCE .. NEED'S.. PSYCHIATRISTS OPINION.. PLACEBOS.. MULTIVITAMINS ANTIOXIDANTS..

Tnx Dr Ajeet Pal Singh
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